MP60-13 PSOAS MUSCLE MASS AS A PREDICTOR OF SURVIVAL IN PATIENTS WHO UNDERGO RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2014MP60-13 PSOAS MUSCLE MASS AS A PREDICTOR OF SURVIVAL IN PATIENTS WHO UNDERGO RADICAL CYSTECTOMY Hamed Ahmadi, Michael Terjimanian, Anna Sadie Chernin, Stephanie Daignault-Newton, Neal All-Attar, Stephen Dailey, Jeffery Montgomery, Alon Z. Weizer, James E. Montie, and Cheryl T. Lee Hamed AhmadiHamed Ahmadi More articles by this author , Michael TerjimanianMichael Terjimanian More articles by this author , Anna Sadie CherninAnna Sadie Chernin More articles by this author , Stephanie Daignault-NewtonStephanie Daignault-Newton More articles by this author , Neal All-AttarNeal All-Attar More articles by this author , Stephen DaileyStephen Dailey More articles by this author , Jeffery MontgomeryJeffery Montgomery More articles by this author , Alon Z. WeizerAlon Z. Weizer More articles by this author , James E. MontieJames E. Montie More articles by this author , and Cheryl T. LeeCheryl T. Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1767AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Morphomic measures of abdominal muscle mass, as physical component of frailty evaluation, are reportedly accurate predictors of early and late operative outcome in patients who undergo major abdominal surgeries. We evaluated the association between CT scan-based psoas muscle mass area and operative outcome of radical cystectomy (RC) and urinary diversion reconstruction. Methods In a retrospective single center study, 442 bladder cancer patients who underwent RC and urinary diversion reconstruction at Department of Urology, University of Michigan between 2007 and 2012 were enrolled. Cross-sectional areas of the left and right psoas muscles at the level of L4 were determined and summed to generate the total cross sectional area of the psoas muscles (TPA). Outcome measures of interest were short-term outcome including length of hospital stay (LOS), 30-day readmission rate (RR) and complication rate (CR); Intermediate-term outcome including 90-day RR and CR as well as 6-month mortality; and long-term outcome including 3-yr overall survival (OS). Multivariate logistic and Cox proportional-hazards regression models were used to determine predictors of operative outcome and OS, respectively. Predictive accuracy of different survival models were also compared using Receiver Operating Characteristic (ROC) curves. Results Mean age of participants and follow up time was 66 y/o (range, 31 – 91) and 2.3 yrs (range, 0.04 – 6.3), respectively. Mean TPA was 2363 mm2 (range, 552 – 4322). Mean LOS was 10 days. 30-day RR and CR were 63/466 (13.5%) and 196/440 (44.5%), respectively. TPA was not associated with any early operative outcome measures. (P>0.05) 90-day RR and CR were 95/466 (20%) and 238/466 (51%), respectively. Thirty patients (6.4%) died within first 6-months from surgery of whom, 21 (70%) died of UCB. TPA was not associated with any intermediate operative outcome measures. (P>0.05) 3-year OS rate was 0.62 (range, 0.56–0.67). TPA (HR= 0.96, 95%CI: 0.93 – 0.98; P= 0.005) was significantly associated with 3-year OS. Patients with TPA at highest quartile had 0.18 survival advantage over those with TPA at lowest quartile 3 years from RC. (P= 0.02) Predictive accuracy of 3-year survival model composed of pathologic stage, age, and comorbidity was increased from 0.74 to 0.80 when TPA was included in the model. Conclusions Muscle mass does not seem to be an independent predictor of early morbidity and mortality following RC. However, it is an independent predictor of long term survival, regardless of age, pathologic stage, and comorbidities. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e637 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Hamed Ahmadi More articles by this author Michael Terjimanian More articles by this author Anna Sadie Chernin More articles by this author Stephanie Daignault-Newton More articles by this author Neal All-Attar More articles by this author Stephen Dailey More articles by this author Jeffery Montgomery More articles by this author Alon Z. Weizer More articles by this author James E. Montie More articles by this author Cheryl T. Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...